Apparatus and method for delivering surgical tissue connectors into an abdominal cavity and removing the surgical tissue connectors from the abdominal cavity

ABSTRACT

The present invention is directed to an apparatus and its method of use in delivering surgical tissue connectors into an area of the body and removing the surgical tissue connectors from the body area. Svlore specifically, the present invention is directed to a surgical tissue connector apparatus having at least two tissue connectors connected by a length of cord and a delivery and removal tube. At least one of the tissue connectors has a base with a tapered, beveled or chamfered surface projecting from one end of the base. A hook or other type of tissue connector projects from the opposite side of the base. The hook is positioned on the base where a peripheral side surface of the base shields the hook from unintentionally snagging objects. The base peripheral surface is also dimensioned to slide easily through an interior bore of the tube. This enables the base and the projecting hook to be easily delivered through the tube into an area of the body. The chamfered or tapered surface on the base is positioned to engage with the distal end opening of the tube and direct the base into the center of the tube as the surgical tissue connector is retracted info the tube from the body area in removing the apparatus from the abdominal cavity.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention is directed to an apparatus and its method of usein delivering surgical tissue connectors into an area of the body andremoving the surgical tissue connectors from the body area. Morespecifically, the present invention is directed to a surgical tissueconnector apparatus having at least two tissue connectors connected by alength of cord and a delivery and removal tube. At least one of thetissue connectors has a base with a tapered, beveled or chamferedsurface projecting from one end of the base. A hook or other type oftissue connector projects from the opposite side of the base. The hookis positioned on the base where a peripheral side surface of the baseshields the hook from unintentionally snagging objects. The baseperipheral surface is also dimensioned to slide easily through aninterior bore of the tube. This enables the base and the projecting hookto be easily delivered through the tube into an area of the body. Thechamfered or tapered surface on the base is positioned to engage withthe distal end opening of the tube and direct the base into the centerof the tube as the surgical tissue connector is retracted into the tubefrom the body area in removing the apparatus from the abdominal cavity.

2. Description of the Related Art

In laparoscopic surgery procedures, it is often necessary to passsurgical tissue connectors though a cannula, trocar, endosope or othersimilar device that is positioned through an incision in the body todeliver the tissue connectors into an area of the body where theconnectors are used in a laparoscopic surgery procedure. A disadvantageassociated with the current constructions of surgical tissue connectorsand the tubular delivery device used to deliver the connectors into thebody and then remove the connectors from the body is that often theconnectors will snag or catch a portion of the tubular delivery devicebeing used to deliver or retrieve the connectors.

SUMMARY OF THE INVENTION

The present invention overcomes the above described disadvantagesassociated with tissue connectors used in laparoscopic and other surgeryprocedures by providing an apparatus that facilitates the delivery of asurgical tissue connector through a tubular delivery device and into thebody, and the subsequent removal of the surgical tissue connectorthrough the tubular device from the body.

The basic construction of the apparatus of the invention includes atleast two surgical tissue connectors. Each tissue connector has a base.The base has a side surface that extends around the base, and a distalend surface and proximal end surface at the opposite ends of the sidesurface. In one embodiment of the tissue connector, the base sidesurface is a cylindrical surface having a center axis that definesmutually perpendicular axial and radial directions relative to the base.

A hook is secured stationary to and projects axially from the basedistal end surface. The hook has a shank portion that extends axiallyfrom the base distal end surface. The shank portion is substantiallyparallel with the base center axis but spaced radially from the centeraxis. The hook also has a bent portion that extends from the shankportion across the base distal end surface and through the center axisto a distal end tip of the hook. The end tip and the shank are radiallyspaced on opposite sides of the base center axis and the end tip doesnot project radially beyond the base side surface Thereby, the base sidesurface shields the end tip of the hook from snagging or catching withother objects.

The base proximal end surface of at least one of the connectors has achamfered or tapered configuration that tapers as the proximal endsurface extends axially away from the base side surface. In oneembodiment of the apparatus, the base proximal end surface has a conicalconfiguration. The conical configuration of the base proximal endsurface extends axially from the base side surface to an apex that iscentered on the base distal end surface.

The apparatus also includes a length of cord that extends between theproximal end surfaces of the tissue connectors. In one embodiment of theapparatus, the length of the cord extending between the tissueconnectors is flexible and can be adjusted.

The apparatus also includes a tissue connector delivery and removaltube. In one embodiment of the apparatus, the tube has a straight lengthwith opposite proximal and distal ends, and a cylindrical interior borethat extends through the length of the tube. The interior bore has aninterior diameter dimension that is slightly larger than an exteriordiameter dimension of the base cylindrical side surface. This enablesthe tissue connectors to easily slide through the interior bore of thetube then delivering the tissue connectors through the tube, or removingthe tissue connector through the tube. Additionally, the taperedconfiguration of the base proximal end surface of at least one of thetissue connectors enables that tissue connector to be easily pulled intothe tube at the tube distal end. Removing the apparatus by pulling theother tissue connector through the tube distal end and then pulling thecord and the tapered tissue connector into the tube causes the taperedconfiguration of the base proximal end surface to first enter the end ofthe tube, whereby the tapered configuration centers the base cylindricalside surface relative to the tube interior bore as the tapered proximalend surface is pulled into the tube interior bore. With the base sidesurface centered in the tube interior bore, the hook projecting from thebase distal end surface is prevented from snagging or catching thedistal end of the tube as the tissue connector is pulled into andthrough the tube.

The apparatus also includes a rod having a straight length that isdimensioned to be inserted into the tube proximal end to push the tissueconnectors and their connecting cord through the tube interior bore todeliver the tissue connectors and the connecting cord from the tubedistal end.

When use of the apparatus in the surgical procedure is complete, theapparatus can be easily removed from the body by inserting the tubethrough a cannula or an incision to position the tube distal endadjacent the connectors and the cord, and then inserting a surgicalgrasper through the tube and grasping the tissue connector without thetapered end surface. The tissue connector is grasped at its hook.Retracting the grasper back through the tube will move the graspedconnector into the tube and then pull the cord into the tube interiorbore. As the cord is pulled through the tube bore it pulls the taperedproximal end surfaces of the other tissue connectors into the bore. Thetapered proximal end surface of the connector will center the connectorand the cylindrical side surface of the connector relative to theinterior bore as the connector enters the tube distal end and passesthrough the interior bore. The cylindrical side surface of the connectorprevents the hook extending from the distal end surface of the connectorfrom snagging or catching against the tube distal end as the connectorenters into and passes through the tube interior bore.

As described above, the apparatus of the invention and its method of usefacilitate the delivery of surgical tissue connectors to a surgery siteand facilitate the removal of the surgical tissue connectors from thesurgery site.

DESCRIPTION OF THE DRAWINGS

Further features of the apparatus of the invention and its method of useare set forth in the following detailed description of the apparatus andmethod and are shown in the drawing figures.

FIGS. 1 a and 1 b show an embodiment of the apparatus comprising a pairof tissue connectors connected by a cord where one of the tissueconnectors employs a releasable one-way cord lock that enables adjustingthe length of the portion of the cord extending between the pair oftissue connectors.

FIGS. 2 a and 2 b show further embodiments of the apparatus similar tothat of FIGS. 1 a and 1 b,

FIG. 3 is a perspective view of one of the tissue connectors.

FIG. 4 is a plan view of the tissue connector of FIG. 3.

FIGS. 5 a and 5 b illustrate the assembly of the tissue connector ofFIG. 3.

FIG. 6 is a perspective view of a further embodiment of a tissueconnector.

FIG. 7 is a plan view of the tissue connector of FIG. 6,

FIGS. 8 a and 8 b illustrate the assembly of the tissue connector ofFIG. 6.

FIG. 9 is a perspective view of a further embodiment of a tissueconnector.

FIG. 10 is a side view of the tissue connector of FIG. 9.

FIG. 11 is cross-section view of the tissue connector of FIG. 9.

FIG. 12 is a perspective view of the disassembled component parts of thetissue connector of FIG. 9.

FIG. 13 is a cross-section view of the delivery and removal tube of theapparatus.

FIG. 14 is an end view of the proximal end of the delivery and removaltube.

FIG. 15 is a side view of the delivery rod of the apparatus.

FIG. 16 is a partial sectioned view of the apparatus illustrating themethod of removing a tissue connector of the apparatus from an abdominalcavity using the delivery and removal tube of the apparatus.

FIG. 17 is a partial sectioned view of the apparatus furtherillustrating the method of removing a tissue connector of the apparatusfrom an abdominal cavity using the delivery and removal tube of theapparatus.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

FIGS. 1A and 1B show an embodiment of the tissue connector apparatus ofthe invention that is constructed to facilitate the delivery of thetissue connectors through a cannula or other type of tubular deliverydevice to a surgical site of a body for use in a laparoscopic surgery orother type of surgical procedure, and facilitate the removal of thetissue connectors of the apparatus following completion of theprocedure. As is conventional with laparoscopic apparatus, the componentparts of the apparatus are dimensioned to be inserted through anincision or through a cannula, trocar, endoscope or other type oftubular delivery device extending into the body to position theapparatus at a surgery site. All of the component parts of the apparatusto be described are constructed of biocompatible materials.

The first embodiment of the apparatus is shown in FIGS. 1 a and 1 b. Theembodiment shown is basically comprised of a first tissue connector 12,a second tissue connector 14 and a length of cord 16 extending betweenand connecting the two tissue connectors. The cord could be a suture, IVtubing or other equivalent types of cord and could be one piece orseveral pieces connected together.

Details of the construction of the first tissue connector 12 are shownin FIGS. 3, 4, 5 a and 5 b. The first tissue connector 12 is comprisedof a base 18 and a hook 22. The base 18 for the most part is a solidsingle piece of material having a side exterior surface that extendscompletely around the base. In the embodiment shown in the drawingfigures, the side surface 24 is cylindrical. The cylindrical surface 24has a center axis 26 that defines mutually perpendicular axial andradial directions relative to the base. The base also has a proximal endsurface 28 at one axial end of the base and a distal end surface 30 atan opposite axial end of the base.

The proximal end surface 28 is chamfered or tapers as it extends axiallyaway from the base side surface 24. In the embodiment shown, theproximal end surface 28 has a conical configuration with a circularperipheral edge 32 defined by the intersection of the proximal endsurface with the cylindrical base side surface 24. The proximal endsurface 28 tapers as it extends axially from the base side surface 24 toan apex end 34 of the proximal end surface.

The base distal end surface 30 is substantially flat. The distal endsurface 30 has a circular peripheral edge 36 defined by the intersectionof the distal end surface with the cylindrical base side surface 24.

A hook hole 38 is formed in the base distal end surface 30. The hookhole 38 is spaced radially inwardly from the distal end surfaceperipheral edge 36 and radially from the center axis 26. The hook holeextends axially into the base a short distance from the distal endsurface 30 and does not extend entirely through the base. A center hole42 is also formed in the base at the center of the base distal endsurface 30. The center hole 42 extends axially through the base andemerges at the apex 34 of the base proximal end surface 28. The centerhole 42 has a slightly larger interior diameter dimension adjacent thebase distal end surface 30 than the interior diameter dimension of thehole 42 adjacent the apex 34 of the base proximal end surface 28.

The hook 22 has a straight shank portion 44 extending from a proximalend 46 of the hook. The hook shank portion adjacent the hook proximalend 46 is dimensioned with a cylindrical exterior surface that fitstightly into the hook hole 38 in the base distal end surface 30. Thehook shank portion 34 is secured stationary to the base by laser weldingor other equivalent means. The hook 22 is secured to the base distal endsurface 32 with the hook shank portion 34 extending axially from thedistal end surface 32 substantially parallel with the center axis 26,but radially spaced from the center axis. The hook shank portion 44extending from the distal end surface 30 has a square or other similarcross-section configuration to facilitate grasping the hook with asurgical grasper and preventing the hook shank from rotating in thegrasper. The shank portion 44 extends axially from the base distal endsurface 30 to a bent portion 48 of the hook that extends radially acrossthe distal end surface 30, through the base center axis 26 and to adistal end tip 52 of the hook. The distal end tip 52 and shank portion44 of the hook are each radially spaced on opposite sides of the basecenter axis. The shank portion 44 and end tip 52 are both spaced aradial distance dimension on opposite sides of the center axis 26 thatis smaller than the base radius dimension, whereby the hook bent portionand tip do not project radially beyond the cylindrical side surface ofthe base. Although the hook 22 is shown as the part of the tissueconnector 12 that is removably attachable to body tissue, otherequivalent devices that do not project radially beyond the side surfaceof the base could be used.

In the embodiment of the apparatus shown in FIGS. 1 a and 1 b, the cord16 has a flexible length with opposite first 54 and second 56 ends. Thecord first end 54 passes through the center hole 42 of the first tissueconnector 12 from the proximal end surface 28 to the distal end surface30. A knot 58 is tied in the cord first end 54. A medical grade glue,for example cyanoacrylate is applied to the knot. The cord is pulledfrom the base proximal end surface 28 to pull the knot 58 into thecenter hole 42 in the base distal end surface 30. The knot 56 is toolarge to pass though the smaller portion of the center hole 42 thatemerges from the apex 34 of the proximal end surface 28. Thereby, thecord first end 54 is secured to the first tissue connector 12 with thecord extending from the base proximal end surface 28 of the tissueconnector.

FIGS. 6, 7, 8 a and 8 b show an alternate embodiment of the first tissueconnector where a post 62 of an eyelet ring 64 is inserted through thebase center hole 42 from the base proximal end surface 28. The post 62is secured to the base by laser welding the end of the post 62 in thecenter hole at the base distal end surface 32. The eyelet ring 64 couldbe secured to the base by other equivalent means. The first end 54 ofthe cord 16 is then secured to the eyelet 64 by a knot being tied in thecord around the eyelet ring 64 and the knot being secured by a medicalgrade glue.

Details of the construction of the second tissue connector 14 are shownin FIGS. 9, 10, 11 and 12,

The second tissue connector 14 is also basically comprised of a base 68and a hook 72 projecting from the base. The base 68 has a side surface74 that extends completely around the base. The in embodiment shown inthe drawing figures the side surface 74 is cylindrical and has a centeraxis 76 that defines mutually perpendicular axial and radial directionsrelative to the base 68. The base 68 also has a proximal end surface 78at one axial end of the base and a distal end surface 80 at the oppositeaxial end of the base.

The base proximal end surface 78 is chamfered or tapers as it extendsaxially away from the cylindrical side surface 74. In the embodiment ofthe second tissue connector 68 shown, the base proximal end surface 78has a conical configuration with a circular peripheral edge 82 definedby the intersection of the proximal end surface 78 with the cylindricalbase side surface 74. The proximal end surface 78 tapers as it extendsfrom the cylindrical side surface 74 to an apex 84 on the proximal endsurface. A hole 86 passes through the center of the apex 84 of theproximal end surface 78 to an interior bore of the base that isdescribed later.

The base distal end surface 80 is substantially flat. The distal endsurface 80 has a circular peripheral edge 88 defined by the intersectionof the distal end surface 80 and the cylindrical base side surface 74.

A hook hole 92 is formed in the base distal end surface 80. The hookhole 92 is spaced radially inwardly from the distal end surfaceperipheral edge 88 and radially from the center axis 76. The hook hole92 extends axially into the base a short distance from the distal endsurface 80 and does not extend entirely through the base.

The hook 72 of the second tissue connector 14 has substantially the sameconstruction as the hook 22 of the first tissue connector 12. The hook72 has a straight shank portion 94 extending from a proximal end 96 ofthe hook. Adjacent the proximal end 96 the hook shank portion has acylindrical configuration dimensioned to fit tightly into the hook hole88 on the distal end surface 80. The hook shank portion 94 is secured tothe base distal end surface 80 by laser welding or other equivalentmeans. The hook shank portion 94 extends axially from the base distalend surface 80 substantially parallel with the base center axis 76 butspaced radially from the center axis. The shank portion 94 extendingfrom the distal end surface 80 has a square or other similarcross-section configuration that facilitates grasping the shank portionwith surgical graspers and preventing rotation of the shank portion inthe graspers. The hook shank portion 94 extends axially from the base toa bent portion 98 of the hook that extends radially over the base distalend surface 80 and through the base center axis 76. The hook bentportion 98 extends from the shank portion 94 to a distal end tip 100 ofthe hook. The hook distal end tip 100 and shank portion 94 are bothspaced a radial distance dimension on opposite sides of the center axis76 that is smaller than the base radius dimension, whereby the hook bentportion and the distal end tip 100 do not project radially beyond thecylindrical side surface 74 of the base. Although the hook 72 is shownas the part of the tissue connector that is removably attachable to bodytissue, other equivalent devices that do not project radially beyond theside surface of the base could be used Additionally, although bothtissue connectors 12, 14 are described as having chamfered or taperedsurfaces 28, 78, it is not necessary that both have tapered surfaces forthe intended functioning of the apparatus,

Although the first 12 and second 14 tissue connectors have similarconstructions as discussed above, the second tissue connector 14 isconstructed with a releasable one-way cord lock that enables the lengthof the portion of the cord 16 extending between the two tissueconnectors 12, 14 to be adjusted.

The second tissue connector base 68 has a tubular configuration with acylindrical housing wall having the base cylindrical side surface 74 onits exterior, and a hollow interior bore 102 extending through thelength of the housing wall interior.

A disk shaped cap 104 is secured to a distal end of the base housingwall by laser welding or other equivalent means. The disk-shaped cap 104defines the distal and surface 80 of the base.

A rod or pin 106 is secured to the base 68 in the base interior bore102. The rod 106 extends radially across the base interior bore 102adjacent the proximal end surface 78 of the base. Opposite ends of therod 106 are secured to the interior surface of the base cylindricalhousing.

The cord 6 is secured to the second tissue connector 14 inside the baseinterior bore 102. The second end 56 of the cord 16 extends through thecenter hole 86 in the apex of the base proximal end surface 78 and intothe hollow interior bore 102 of the base. An intermediate portion of thecord 112 is wrapped around the rod 106 in the base interior, therebyattaching the cord 16 to the second tissue connector 14. Theintermediate portion of the cord 112 is wrapped around the rod 106 bybeing tied in a knot around the rod. The preferred knot 112 is a Blunterhitch knot. A first portion 114 of the cord length extends from theintermediate portion 112 though the base center hole 86. Thee cord firstportion 114 extends from the proximal end surface 78 of the base to thecord first end 54 attached to the first tissue connector 12. A secondportion of the cord length 116 extends from the cord intermediateportion 112 through a side hole 118 in the base cylindrical side surface74 and the proximal end surface 78. The side hole 118 is provided toseparate the cord first portion 114 and the cord second portion 116 toprevent tangling. The side hole 118 also allows for a greater angle thatthe cord second portion 116 can be pulled from the connector. The secondportion of the cord 116 extends from second tissue connector 14 to asecond, free end 122 of a cord.

The releasable one-way cord lock is comprised of a pair slots 124 thatare formed in radially opposite sides of the cylindrical side wall ofthe base 68. As seen in the drawing figures, the slots 124 extendaxially along a portion of the cylindrical wall of the base 68 and arepositioned radially to one side of the base center axis 76 A lock pin126 is positioned in the slots 124 and extends from one slot 124 acrossthe interior bore of the base 68 to the other slot. The lock pin 126slides axially along the slots 124.

An actuator 128 is mounted on the base cylindrical side surface 74 andis connected to the lock pin 126 inside the base. The actuator 128 isformed as cylindrical sleeve that surrounds the base cylindrical sidesurface 74 The actuator 128 is mounted on the cylindrical side surface74 of the base 68 for axially reciprocating movements between first andsecond positions of the actuator 128 relative to the base 68. Theopposite ends of the lock pin 126 project beyond the slots 124 in thebase cylindrical side surface 74 and are secured in opposite sides ofthe actuator 128. Moving the actuator 128 to its first position shown inFIG. 11 causes the lock pin 126 to engage against the cord intermediateportion 112 that is wrapped around the rod 106. In FIG. 11, the pin 126prevents the knot 112 from rotating counterclockwise around the rod 106when the knot 112 is in a 3 o'clock position, or to the right of the rodas shown in FIG. 11 and the cord first portion 114 is pulled. Theengagement of the lock pin 126 against the cord intermediate portion orknot 112 locks the cord and prevents the first portion of the cordlength 114 from being pulled from the proximal end surface 78 of thesecond tissue connector 14. However, in the position of the knot 112shown in FIG. 11 the cord second portion 116 can be pulled from thesecond tissue connector 14 to shorten the length of the cord firstportion 114, but the cord first portion 114 cannot be pulled from theconnector. Moving the actuator 128 to its second position causes thelock pin 126 to disengage from the cord intermediate portion or knot112. With the pin 126 moved upward, the cord first portion 114 can bepulled to move the knot 112 counterclockwise from the 3 o'clock positionto a 6 o'clock position as viewed in FIG. 11. This allows the length ofthe cord first portion 114 extending between the second tissue connector14 and the first tissue connector 12 to be pulled from the second tissueconnector 14 to adjust or increase the length of the cord first portion114. With the pin 126 moved upward the cord second portion 116 can alsobe pulled from the connector.

A biasing device 1132 urges the lock pin 126 to its first position shownin FIG. 11. In the drawing figures the biasing device 132 is coiledspring. Other equivalent types of biasing devices could be employed.

The slot 124 and the pin 126 are off center relative to the basecylindrical side surface 74 to facilitate the knot 112 pushing the pin126 upward against the bias of the spring 132 when the cord secondportion 116 is pulled and the knot 112 moves clockwise from the 6o'clock position to the 3 o'clock position relative to the rod 106.

Tissue connectors having one way cord locks such as that described aboveare disclosed in the currently pending international patent applicationNo. PCT/US2011/01494 which is assigned to the assignee of this inventionand is incorporated herein by reference.

FIG. 2 a shows a further embodiment of the apparatus of the inventioncomprising the first tissue connector 12 and the second tissue connector14 connected by the length of cord 16. However, the first end of thelength of cord 16 is connected to the first tissue connector 12 havingthe eyelet ring 64 that was described earlier. In addition, a secondlength of cord 134 connects a third tissue connector 136 to the firsttissue connector 12. The construction of the third tissue connector 136is substantially the same as that of the second tissue connector 14described earlier. In the embodiment of FIG. 2A, at least two of thethree tissue connectors would require tapered proximal end surfaces inorder for the apparatus to function as intending in removing theapparatus from a surgical site as described be low.

FIG. 2B shows a still further embodiment of the apparatus where thetissue connector hook 72 or other equivalent device is not directlyconnected to the base 68 of the second tissue connector 14, but isconnected by a further length of suture 138.

The apparatus of the invention also comprises a tissue connector deliverand removal tube 142 shown in FIGS. 13 and 14, and a delivery rod 144shown in FIG. 15.

In one embodiment of the apparatus, the tube 142 has a straight lengthwith opposite proximal 146 and distal 148 ends. An interior bore havinga smooth cylindrical interior surface 152 extends through the length ofthe tube. The cylindrical interior surface 152 has an interior diameterdimension that is just slightly larger than the exterior diameterdimension of the first tissue connector base cylindrical side surface 24and the second tissue connector base cylindrical side surface 74. Thisenables the tissue connectors 12, 14 to easily slide through theinterior bore of the tube when delivering the tissue connectors throughthe tube, or removing the tissue connectors through the tube.

The delivery rod 144 has a straight length that is dimensioned to beinserted into the tube proximal end 146 to push the tissue connectors12, 14 and the connecting cord 16 through the tube interior bore todeliver the tissue connectors and the connecting cord from the tubedistal end 142 and to a surgical site in a body.

Additionally, the tapered configuration of the base proximal end surface28 of the first tissue connector 12 and the tapered configuration of thebase proximal end surface 78 of the second tissue connector 14 enablesthe tissue connectors to be easily pulled into the interior bore of thetube 42 at the tube distal end 148. However, it is only necessary thatone tissue connector 12 have a tapered proximal end surface in a twoconnector embodiment of the apparatus such as that shown in FIGS. 1A and1B, When it is desired to remove the tissue connectors 12, 14 from asurgical site in an area of the body, the tube distal end 142 ispositioned in the area by inserting the distal end through a cannula orthrough an incision to position the tube distal end 148 at the surgicalsite. An instrument, for example a surgical grasper is then insertedthrough the tube 142 until it emerges from the tube distal end 148. Thesurgical grasper then grasps the second tissue connector 14 at the hook72. The surgical grasper is then removed through the tube 142 moving thesecond connector 14 hook first into the tube distal end and pulling thecord into the tube distal end 142. The cord 16 is then continued to bepulled through the tube until the tapered configuration of the baseproximal end surface 28 of the first tissue connector 12 is pulled intothe tube distal end 148. The tapered configuration of the proximal endsurface 28 centers the base cylindrical side surface 24 of the firsttissue connector 12 relative the tube interior bore as the taperedproximal end surface is pulled into the tube interior bore. With thebase cylindrical side surface 24 centered in the interior bore of thetube 142, the hook 22 projecting from the base distal end surface 30 isprevented from snagging or catching the distal end 148 of the tube 142as the first tissue connector is pulled into an through the tube.

Thus, as described above, the apparatus of the invention and its methodof use facilitate the delivery of surgical tissue connectors to alaparoscopic surgical site and facilitate the removal of the surgicalconnectors from the surgical site.

As various modifications could be made in the apparatus herein describedand illustrated and its method of use without departing from the scopeof the invention, it is intended that all the matter contained in theforegoing description or shown in the accompanying drawings shall beinterpreted as illustrative rather than limiting. Thus, the breath andscope of the present invention should not be limited by any of the abovedescribed exemplary embodiments, but should be defined only inaccordance with the following claims appended hereto and theirequivalents.

1-20. (canceled)
 21. A tissue connector apparatus comprising: a tissueconnector (14), having a base (68) with a side surface (74), the sidesurface (74) having a center axis that defines mutually perpendicularaxial and radial directions relative to the base (68), the base (68)having a radius dimension between the center axis and the side surface,the base having a proximal end surface (78) and a distal end surface(80) at axially opposite ends of the side surface (74); a hook (72)secured to the base (68); and a cord (16, 54, 56, 114, 112, 116)characterized by a first end (54) and a second end (56), and said cordsecond end characterized by a first portion (114), a second portion(116) and an intermediate portion (112), said cord connected to andextending from the base proximal end surface (78); and a releasableone-way cord lock through which the cord second end (56, 114, 112, 116)passes, said releasable one-way cord lock being operable to lock thecord second end (56, 114, 112, 116) to the base (68) and thereby adjustthe length of the cord (56, 114) extending from the tissue connector(14); wherein the tissue connector (14) has an interior bore (102), anda pin (106) extending across the interior bore, and an intermediateportion of the cord (112) is tied in a knot around the pin (106),thereby attaching the cord second end (54) to the tissue connector (14);and the releasable one-way cord lock comprises a lock pin (126) axiallyslidably disposed in a first axially extending slot (124) disposed inthe base, said lock pin (126) extending across the interior bore of thebase (68), and a sleeve (128) surrounding the base side surface (74) andaxially slidable between first and second positions relative to thefirst base (68), said sleeve (128) secured to the lock pin (126),whereby movement of the sleeve (128) causes the lock pin (126) to engageagainst the cord intermediate portion (112) to prevent the cordintermediate portion (112) from rotating in a direction corresponding tomovement of the cord second end (56) away from the proximal end surface(78) of the tissue connector (14).
 22. The apparatus of claim 21,wherein the lock pin extends from the sleeve, through the first axiallyextending slot (124) to a second axially extending slot (124), andprojects through the first and second axially extending slots and issecured to the sleeve.
 23. The apparatus of claim 21, further comprisinga biasing device (132) disposed within the bore (102), said biasingdevice operable to urge the lock pin (126) toward the intermediateportion (112).
 24. The apparatus of claim 22, further comprising abiasing device (132) disposed within the bore (102), said biasing deviceoperable to urge the lock pin (126) toward the intermediate portion(112).
 25. The apparatus of claim 21, further comprising: a side hole(118) in the base (68), wherein a portion (116) of the cord extendsthrough the side hole (118) to the exterior of the tissue connector(14).
 26. The apparatus of claim 22, further comprising: a side hole(118) in the base (68), wherein a portion (116) of the cord extendsthrough the side hole (118) to the exterior of the tissue connector(14).
 27. The apparatus of claim 23, further comprising: a side hole(118) in the base (68), wherein a portion (116) of the cord extendsthrough the side hole (118) to the exterior of the tissue connector(14).
 28. The apparatus of claim 21, further comprising: an additionaltissue connector disposed at the first end of the cord.
 29. Theapparatus of claim 28, wherein the additional tissue connector (12) isalso characterized by: an additional base (18) with a side surface (24),the side surface (24) having a center axis that defines mutuallyperpendicular axial and radial directions relative to the base (18), theadditional base having a radius dimension between the center axis andthe side surface, the base having a proximal end surface (28) and adistal end surface (30) at axially opposite ends of the base sidesurface (24); the additional base proximal end surface (28) having atapered configuration that tapers as the proximal end surface (28)extends axially away from the additional base side surface (24); anadditional hook (22) secured to the additional base (18); wherein thefirst end (54) is secured to the additional base proximal end surface(28).
 30. The apparatus of claim 29, further comprising: a third tissueconnector connected to the additional tissue connector through a secondcord (134).
 31. The apparatus of claim 21 wherein the hook comprises: ashank portion (44) that extends axially from the base distal end surface(30), the shank portion (44) being parallel with and radially spacedfrom the center axis, the hook having a bent portion (48) that extendsfrom the shank portion (44) across the center axis to an end tip (52) ofthe hook (22), the hook end tip (52) and the hook shank portion (44)each being radially spaced on opposite sides of the center axis byradial distance dimensions that are smaller than the base radiusdimension; and
 32. The apparatus of claim 21, further comprising: atissue connector delivery and removal tube (142), the tube having aninterior bore with an interior diameter dimension that is larger than adiameter dimension of the base side surface (74).
 33. The apparatus ofclaim 21, further comprising: the base proximal end surface (78) havinga conical configuration.
 34. The apparatus of claim 21, furthercomprising: the length of cord (16) extending from the base proximal endsurface (78) being adjustable in length.
 35. The apparatus of claim 21,further comprising: the base distal end surface (50) having a circularperipheral edge (88) that is coaxial with the center axis; and the hookbent portion (98) and the hook end tip (100) do not extend radiallybeyond the distal end surface peripheral edge.